超声引导腹横肌平面阻滞复合右美托咪定对老年腹股沟斜疝手术患者麻醉效果的影响

目的探讨超声引导腹横肌平面阻滞（TAPB）复合右美托咪定（DEX）对老年腹股沟斜疝手术患者麻醉效果的影响。 方法选取2017年3月至2018年9月河北省沧州中西医结合医院收治的44例老年腹股沟斜疝手术患者，采用随机数字表法将其分为对照组（22例）和观察组（22例），2组均行平片无张力疝修补术，其中对照组术中给予局部浸润麻醉，观察组术中给予TAPB复合DEX麻醉。比较2组麻醉效果及麻醉起效、持续时间；对比2组麻醉后2 h的神经阻滞、镇痛及镇静评分；统计2组治疗期间的不良反应发率。 结果观察组总有效率为95.45%，高于对照组的77.27%（P<0.05）。观察组感觉神经阻滞、运动神经阻滞起效时间均短于对照组，维持时间均长于对照组（P<0.05）。麻醉后2 h，2组Bromage、Ramsay评分比较无统计学差异（P>0.05）；观察组Prince-Henry评分低于对照组（P<0.05）。观察组不良反应发生率为9.09%，低于对照组的36.36%（P<0.05）。 结论TAPB复合DEX对老年腹股沟斜疝手术患者镇痛作用较好，可提高其麻醉效果，且具有较高安全性。

Effect of ultrasound guided transverse adbominis plane block combined with dexmedetomidine on anesthesia in elderly patients with inguinal hernia

ObjectiveTo investigate the effects of ultrasound-guided transverse abdominis plane block (TAPB) combined with dexmedetomidine (DEX) on anesthetic in elderly patients with inguinal hernia. MethodsA total of 44 elderly patients with indirect inguinal hernia treated in Cangzhou Hospital of Integrated TCM-WM between March 2017 and September 2018 were selected as the research subjects. Random number table method was used to divide them into the control group (n=22) and the observation group (n=22). Tension-free hernia repair was performed in both groups, the control group was given local infiltration anesthesia in surgery, and the observation group was given anesthesia with TAPB and DEX. The anesthesia effects onset time and duration of anesthesia in the two groups were compared. The scores of the nerve block, analgesia and sedation at 2 hours after anesthesia in both groups were compared. The incidence of adverse reactions during the two groups were counted. ResultsThe total satisfaction rate of anesthesia effect in the observation group was 95.45%, which was higher than 77.27% in the control group (P<0.05). The onset time of sensory nerve block and motor nerve block in the observation group were shorter than those in the control group, and their durations were longer than those in the control group (P<0.05). At 2 hours after anesthesia, the scores of Bromage and Ramsay in the two groups were not statistically different (P>0.05); the score of Prince-Henry in the observation group was lower than that in the control group (P<0.05). The incidence of adverse reactions in the observation group was 9.09%, which was lower than the 36.36% in the control group (P<0.05). ConclusionTAPB combined with DEX has good analgesic effects on elderly patients in inguinal hernia surgery, can improve the effect of anesthesia, and has high safety.